Diagnostics

15 pages, 378 KiB

Open AccessArticle

Excessive Daytime Sleepiness in Hypertensive Patients: The Role of Major Depressive Disorder

by Alexandre Younes, Camille Point, Benjamin Wacquier, Jean-Pol Lanquart and Matthieu Hein

Diagnostics 2024, 14(17), 1854; https://doi.org/10.3390/diagnostics14171854 (registering DOI) - 24 Aug 2024

There is a special relationship between major depressive disorder and excessive daytime sleepiness. However, given the negative impact of excessive daytime sleepiness on life quality and cardiovascular outcome in hypertensive patients, the objective of this study was to investigate the potential role played [...] Read more.

There is a special relationship between major depressive disorder and excessive daytime sleepiness. However, given the negative impact of excessive daytime sleepiness on life quality and cardiovascular outcome in hypertensive patients, the objective of this study was to investigate the potential role played by major depressive disorder in the occurrence of this complaint for this particular subpopulation. Data from 1404 hypertensive patients recruited from the Sleep Unit’s polysomnographic recordings database were analyzed. A score >10 on the Epworth Sleepiness Scale was used to define excessive daytime sleepiness in this study. Logistic regression analyses were performed to investigate the risk of excessive daytime sleepiness associated with major depressive disorder in hypertensive patients. Excessive daytime sleepiness was frequent (40.0%) in our sample of hypertensive patients. After adjustments for major confounding factors, multivariate logistic regression analyses demonstrated that unlike remitted major depressive disorder, only current major depressive disorder was associated with a higher risk of excessive daytime sleepiness in hypertensive patients. Given this potential implication of current major depressive disorder in the occurrence of excessive daytime sleepiness for hypertensive patients, it is therefore essential to achieve the complete remission of this psychiatric disorder to avoid negative consequences associated with this complaint in this particular subpopulation. Full article

(This article belongs to the Special Issue Hypertension: Diagnosis and Management)

15 pages, 601 KiB

Open AccessArticle

Enhanced Immunohistochemistry Interpretation with a Machine Learning-Based Expert System

by Anca Iulia Neagu, Diana Gina Poalelungi, Ana Fulga, Marius Neagu, Iuliu Fulga and Aurel Nechita

Diagnostics 2024, 14(17), 1853; https://doi.org/10.3390/diagnostics14171853 (registering DOI) - 24 Aug 2024

Abstract

Background: In recent decades, machine-learning (ML) technologies have advanced the management of high-dimensional and complex cancer data by developing reliable and user-friendly automated diagnostic tools for clinical applications. Immunohistochemistry (IHC) is an essential staining method that enables the identification of cellular origins by [...] Read more.

Background: In recent decades, machine-learning (ML) technologies have advanced the management of high-dimensional and complex cancer data by developing reliable and user-friendly automated diagnostic tools for clinical applications. Immunohistochemistry (IHC) is an essential staining method that enables the identification of cellular origins by analyzing the expression of specific antigens within tissue samples. The aim of this study was to identify a model that could predict histopathological diagnoses based on specific immunohistochemical markers. Methods: The XGBoost learning model was applied, where the input variable (target variable) was the histopathological diagnosis and the predictors (independent variables influencing the target variable) were the immunohistochemical markers. Results: Our study demonstrated a precision rate of 85.97% within the dataset, indicating a high level of performance and suggesting that the model is generally reliable in producing accurate predictions. Conclusions: This study demonstrated the feasibility and clinical efficacy of utilizing the probabilistic decision tree algorithm to differentiate tumor diagnoses according to immunohistochemistry profiles. Full article

(This article belongs to the Section Pathology and Molecular Diagnostics)

11 pages, 507 KiB

Open AccessArticle

Urine Protein to Creatinine Ratio for the Assessment of Bevacizumab-Associated Proteinuria in Patients with Gynecologic Cancers: A Diagnostic and Quality Improvement Study

by Kuan-Ju Huang, Wen-Chun Chang, Chi-Hau Chen, Wei-Chen Lin, William Wei-Lin Pan, Hao-I Hsieh, Yu-Hsiung Hsieh, Lin-Hung Wei and Bor-Ching Sheu

Diagnostics 2024, 14(17), 1852; https://doi.org/10.3390/diagnostics14171852 (registering DOI) - 24 Aug 2024

Abstract

Proteinuria is a common adverse event arising from treatment with bevacizumab, requiring diagnostic testing via 24-h urine collection. However, this method is cumbersome. We assessed urine screenings in gynecologic cancer patients from February 2021 to May 2022. Along with a simple urine dipstick [...] Read more.

Proteinuria is a common adverse event arising from treatment with bevacizumab, requiring diagnostic testing via 24-h urine collection. However, this method is cumbersome. We assessed urine screenings in gynecologic cancer patients from February 2021 to May 2022. Along with a simple urine dipstick (UD), the urine microalbumin, total protein, and creatinine were measured and calculated as the urine albumin to creatinine ratio (UACR) and the urine protein to creatinine ratio (UPCR), which were further adjusted through the Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration equations to be estimated and correlated with 24-h urine total protein content. The incremental cost-effectiveness ratio was used for cost analysis. There were 129 urine samples from 36 patients. The sensitivity and specificity for the UACR were 0.56 and 0.97, and for the UPCR, 0.71 and 0.88, respectively. The 24-h TP correlated strongly with the UACR (r = 0.75; p < 0.001) and UPCR (r = 0.79; p < 0.001) and fair for the simple UD (r = 0.35; p < 0.001). The UPCR saves one unnecessary 24-h urine test for less than a dollar compared to a simple UD. The results indicate that using the UPCR could enhance diagnostic accuracy, lower costs, and reduce unnecessary 24-h urine sampling. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of Gynecological Cancers)

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Graphical abstract

22 pages, 8880 KiB

Open AccessArticle

CT Angiography for Aortic Arch Anomalies: Prevalence, Diagnostic Efficacy, and Illustrative Findings

by Radu Octavian Baz, Deria Refi, Cristian Scheau, Any Axelerad, Radu Andrei Baz and Cosmin Niscoveanu

Diagnostics 2024, 14(17), 1851; https://doi.org/10.3390/diagnostics14171851 (registering DOI) - 24 Aug 2024

Abstract

Aortic arch anomalies encompass a diverse spectrum of conditions. Elucidating the prevalence of these anomalies, their impact on patient wellbeing, and the most effective diagnostic tools are crucial steps in ensuring optimal patient care. This paper aims to explore the various presentations of [...] Read more.

Aortic arch anomalies encompass a diverse spectrum of conditions. Elucidating the prevalence of these anomalies, their impact on patient wellbeing, and the most effective diagnostic tools are crucial steps in ensuring optimal patient care. This paper aims to explore the various presentations of aortic arch anomalies, emphasizing the remarkable utility of computed tomography (CT) angiography in their definitive diagnosis and characterization. We conducted a retrospective study on patients who were submitted to the CT angiography of the thoracic aorta or supra-aortic trunks, or the contrast-enhanced CT scans of the thorax and/or cervical region between January 2021 and February 2024 in our Hospital. Out of the total of 2350 patients, 18 were diagnosed with aortic arch anomalies, with an average age of approximately 55 years. The aortic arch anomalies identified in the study were as follows: left aortic arch with the aberrant origin of the right subclavian artery, right aortic arch (types I and II), double aortic arch, aortic coarctation, aortic pseudocoarctation, and ductus diverticulum. Although often asymptomatic, aortic arch anomalies require recognition and CT using advanced post-processing techniques is the optimal diagnostic method with the ability to also identify other associated cardiac or vascular malformations. Full article

(This article belongs to the Special Issue Advances in Anatomy—Third Edition)

9 pages, 559 KiB

Open AccessOpinion

Prevention of Initial Periodontitis Is an Investment in the Future

by Anna Maria Heikkinen, Teija Raivisto, Ismo Tapani Räisänen and Timo Sorsa

Diagnostics 2024, 14(17), 1850; https://doi.org/10.3390/diagnostics14171850 (registering DOI) - 24 Aug 2024

Abstract

Background: Periodontal tissue damage is mainly caused by the active form of collagenolytic matrix metalloproteinase-8, aMMP-8, the concentration of which in the mouth rinse can be measured with a mouth rinse chairside-test. The mouth rinse chair side test can be used to identify [...] Read more.

Background: Periodontal tissue damage is mainly caused by the active form of collagenolytic matrix metalloproteinase-8, aMMP-8, the concentration of which in the mouth rinse can be measured with a mouth rinse chairside-test. The mouth rinse chair side test can be used to identify adolescents with a risk of periodontitis. Methods: The data were collected at the Kotka Health Centre (2004–2005, N = 501 and 2014–2015, N = 47) and at the Hämeenlinna Health Centre (2017–2018, N = 125) consisting of adolescents aged 14–17. They underwent a complete periodontal examination, and some were subjected to the aMMP-8-test. Results: We identified bacterial plaques in combination with increased bleeding on probing (BOP), elevated aMMP-8 concentration, smoking and male sex as the main risk factors for initial periodontitis. Approximately 10% of adolescents had subclinical periodontitis, they were not periodontally healthy, but also not sick. They may not develop periodontitis, but they are at the risk. The aMMP-8 test positivity had a stronger association with initial periodontitis than BOP. Conclusions: In addition to identifying risk factors, these adolescents need individual prevention and, if necessary, early treatment. For the periodontal health biomarker aMMP-8, test negativity ([-], ≤20 ng/mL) should be sought. Full article

(This article belongs to the Special Issue Advances in the Diagnosis of Oral Diseases: 2nd Edition)

12 pages, 286 KiB

Open AccessReview

Relapse Predictors in Antineutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitis

by Katarzyna Wawrzycka-Adamczyk, Mariusz Korkosz, Jacek Musiał and Krzysztof Wójcik

Diagnostics 2024, 14(17), 1849; https://doi.org/10.3390/diagnostics14171849 (registering DOI) - 24 Aug 2024

Abstract

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAVs) are a group of rare diseases with a chronic and relapsing course. Recent treatment guidelines offer many therapeutic options depending mainly on the type of diagnosis and disease manifestations. Areas that remain under discussion include whether all [...] Read more.

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAVs) are a group of rare diseases with a chronic and relapsing course. Recent treatment guidelines offer many therapeutic options depending mainly on the type of diagnosis and disease manifestations. Areas that remain under discussion include whether all patients diagnosed with AAV belong to a homogeneous group with a similar prognosis at baseline or if the type and duration of remission-inducing treatment should depend on factors other than just diagnosis and disease severity. The aim of this review is to present the recent literature on the tools available to use while evaluating the risk of relapse in patients upon presentation as well as potential biomarkers of proceeding flare in patients upon remission. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of Vasculitis)

11 pages, 253 KiB

Open AccessArticle

The Mid-Term Effect of Preservative-Free Artificial Tears Containing Hyaluronic Acid on Dry Eye Incidence after Cataract Surgery: A Retrospective Cohort Study

by Chia-Yi Lee, Shun-Fa Yang, Hung-Chi Chen, Ie-Bin Lian, Chin-Te Huang, Jing-Yang Huang and Chao-Kai Chang

Diagnostics 2024, 14(17), 1848; https://doi.org/10.3390/diagnostics14171848 (registering DOI) - 24 Aug 2024

Abstract

The aim of this study is to survey the effectiveness of preservative-free artificial tears containing hyaluronic acid (HA) on post-cataract surgery dry eye disease (DED) prevention. A retrospective cohort study was performed, and patients that received cataract surgeries were divided into either an [...] Read more.

The aim of this study is to survey the effectiveness of preservative-free artificial tears containing hyaluronic acid (HA) on post-cataract surgery dry eye disease (DED) prevention. A retrospective cohort study was performed, and patients that received cataract surgeries were divided into either an HA group or non-HA group depending on the artificial tear they used. A total of 37 and 74 eyes were enrolled into the HA and non-HA groups, respectively, after the selection. The primary outcomes are postoperative superficial keratitis and multiple (>3) DED symptoms. The generalized linear model was utilized to calculate the adjusted odds ratio (aOR) and 95% confidence interval (CI) of primary outcomes between the two groups. There were 10 and 2 episodes of superficial keratitis in the non-HA group and HA group, respectively, and the HA group demonstrated a significantly lower incidence of superficial keratitis (p < 0.001). Moreover, 13 and 5 patients developed multiple DED symptoms in the non-HA and HA groups, and the HA group illustrated fewer multiple DED symptoms (p = 0.024). The lower preoperative tear break-up time (TBUT) was correlated with superficial keratitis in the HA group (p = 0.043), while old age, low preoperative TBUT and ocular surface staining were associated with superficial keratitis in the non-HA group (all p < 0.05). Lower preoperative TBUT was correlated with multiple DED symptoms in the HA group (p = 0.020), while female sex, low preoperative TBUT and any DED symptoms were associated with multiple DED symptoms in the non-HA group (all p < 0.05). In conclusion, the usage of preservative-free artificial tears containing HA is associated with lower postoperative DED events. Full article

(This article belongs to the Special Issue Diagnosis, Treatment and Management of Eye Diseases, Second Edition)

11 pages, 1273 KiB

Open AccessArticle

Inflammatory Protein Panel: Exploring Diagnostic Insights for Peripheral Artery Disease Diagnosis in a Cross-Sectional Study

by Ben Li, Rakan Nassereldine, Farah Shaikh, Houssam Younes, Batool AbuHalimeh, Abdelrahman Zamzam, Rawand Abdin and Mohammad Qadura

Diagnostics 2024, 14(17), 1847; https://doi.org/10.3390/diagnostics14171847 (registering DOI) - 24 Aug 2024

Abstract

Cytokine-induced neutrophil chemoattractant 1 (CINC-1), a cluster of differentiation 95 (CD95), fractalkine, and T-cell immunoglobulin and mucin domain 1 (TIM-1) are circulating proteins known to be involved in inflammation. While their roles have been studied in neurological conditions and cardiovascular diseases, their potential [...] Read more.

Cytokine-induced neutrophil chemoattractant 1 (CINC-1), a cluster of differentiation 95 (CD95), fractalkine, and T-cell immunoglobulin and mucin domain 1 (TIM-1) are circulating proteins known to be involved in inflammation. While their roles have been studied in neurological conditions and cardiovascular diseases, their potential as peripheral artery disease (PAD) biomarkers remain unexplored. We conducted a cross-sectional diagnostic study using data from 476 recruited patients (164 without PAD and 312 with PAD). Plasma levels of CINC-1, CD95, fractalkine, and TIM-1 were measured at baseline. A PAD diagnosis was established at recruitment based on clinical exams and investigations, defined as an ankle-brachial index < 0.9 or toe-brachial index < 0.67 with absent/diminished pedal pulses. Using 10-fold cross-validation, we trained a random forest algorithm, incorporating clinical characteristics and biomarkers that showed differential expression in PAD versus non-PAD patients to predict a PAD diagnosis. Among the proteins tested, CINC-1, CD95, and fractalkine were elevated in PAD vs. non-PAD patients, forming a 3-biomarker panel. Our predictive model achieved an AUROC of 0.85 for a PAD diagnosis using clinical features and this 3-biomarker panel. By combining the clinical characteristics with these biomarkers, we developed an accurate predictive model for a PAD diagnosis. This algorithm can assist in PAD screening, risk stratification, and guiding clinical decisions regarding further vascular assessment, referrals, and medical/surgical management to potentially improve patient outcomes. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of Cardiovascular Disease)

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14 pages, 1618 KiB

Open AccessReview

Modern Approach to Diabetic Retinopathy Diagnostics

by Maria Kąpa, Iga Koryciarz, Natalia Kustosik, Piotr Jurowski and Zofia Pniakowska

Diagnostics 2024, 14(17), 1846; https://doi.org/10.3390/diagnostics14171846 (registering DOI) - 24 Aug 2024

Abstract

This article reviews innovative diagnostic approaches for diabetic retinopathy as the prevalence of diabetes mellitus and its complications continue to escalate. Novel techniques focus on early disease detection. Technological innovations, such as teleophthalmology, smartphone-based photography, artificial intelligence with deep learning, or widefield photography, [...] Read more.

This article reviews innovative diagnostic approaches for diabetic retinopathy as the prevalence of diabetes mellitus and its complications continue to escalate. Novel techniques focus on early disease detection. Technological innovations, such as teleophthalmology, smartphone-based photography, artificial intelligence with deep learning, or widefield photography, can enhance diagnostic accuracy and accelerate the treatment. The review highlights teleophthalmology and handheld photography as promising solutions for remote eye care. These methods revolutionize diabetic retinopathy screening, offering cost-effective and accessible solutions. However, the use of these techniques may be limited by insurance coverage in certain world regions. Ultra-widefield photography offers a comprehensive view of up to 80.0% of the retina in a single image, compared to the 34.0% coverage of the traditional seven-field imaging protocol. It allows retinal imaging without pupil dilation, especially for individuals with compromised mydriasis. However, they also have drawbacks, including high costs, artifacts from eyelashes, eyelid margins, and peripheral distortion. Recent advances in artificial intelligence and machine learning, particularly through convolutional neural networks, are revolutionizing diabetic retinopathy diagnostics, enhancing screening efficiency and accuracy. FDA-approved Artificial Intelligence-powered devices such as LumineticsCore™, EyeArt, and AEYE Diagnostic Screening demonstrate high sensitivity and specificity in diabetic retinopathy detection. While Artificial Intelligence offers the potential to improve patient outcomes and reduce treatment costs, challenges such as dataset biases, high initial costs, and cybersecurity risks must be considered to ensure safety and efficiency. Nanotechnology advancements further enhance diagnosis, offering highly branched polyethyleneimine particles with fluorescein sodium (PEI-NHAc-FS) for better fluorescein angiography or vanadium oxide-based metabolic fingerprinting for early detection. Full article

(This article belongs to the Special Issue Advances in Retinopathy)

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15 pages, 3368 KiB

Open AccessArticle

Commercial Opportunity or Addressing Unmet Needs—Loop-Mediated Isothermal Amplification (LAMP) as the Future of Rapid Diagnostic Testing?

by Jelle J. Feddema, Kenneth D. S. Fernald, Bart J. F. Keijser, Jasper Kieboom and Linda H. M. van de Burgwal

Diagnostics 2024, 14(17), 1845; https://doi.org/10.3390/diagnostics14171845 (registering DOI) - 24 Aug 2024

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Abstract

Loop-Mediated Isothermal Amplification (LAMP) technology is emerging as a rapid pathogen testing method, potentially challenging the RT-PCR “gold standard”. Despite recent advancements, LAMP’s widespread adoption remains limited. This study provides a comprehensive market overview and assesses future growth prospects to aid stakeholders in [...] Read more.

Loop-Mediated Isothermal Amplification (LAMP) technology is emerging as a rapid pathogen testing method, potentially challenging the RT-PCR “gold standard”. Despite recent advancements, LAMP’s widespread adoption remains limited. This study provides a comprehensive market overview and assesses future growth prospects to aid stakeholders in strategic decision-making and policy formulation. Using a dataset of 1134 LAMP patent documents, we analyzed lifecycle and geographic distribution, applicant profiles, CPC code classifications, and patent claims. Additionally, we examined clinical developments from 21 curated clinical trials, focusing on trends, geographic engagement, sponsor types, and the conditions and pathogens investigated. Our analysis highlights LAMP’s potential as a promising rapid pathogen testing alternative, especially in resource-limited areas. It also reveals a gap between clinical research, which targets bacterial and parasitic diseases like malaria, leishmaniasis, and tuberculosis, and basic research and commercial efforts that prioritize viral diseases such as SARS-CoV-2 and influenza. European stakeholders emphasize the societal impact of addressing unmet needs in resource-limited areas, while American and Asian organizations focus more on research, innovation, and commercialization. Full article

(This article belongs to the Section Point-of-Care Diagnostics and Devices)

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9 pages, 1553 KiB

Open AccessCase Report

The Diagnosis of Wilkie’s Syndrome Associated with Nutcracker Syndrome: A Case Report and Literature Review

by Ludovico Abenavoli, Felice Imoletti, Giuseppe Quero, Valentina Bottino, Viviana Facciolo, Giuseppe Guido Maria Scarlata, Francesco Luzza and Domenico Laganà

Diagnostics 2024, 14(17), 1844; https://doi.org/10.3390/diagnostics14171844 - 23 Aug 2024

Viewed by 154

Abstract

Superior mesenteric artery (SMA) syndrome or Wilkie’s syndrome is a vascular compression disorder that causes the abnormal compression of the third portion of the duodenum by the SMA. It has a low incidence rate, which is higher in young women, and is rarely [...] Read more.

Superior mesenteric artery (SMA) syndrome or Wilkie’s syndrome is a vascular compression disorder that causes the abnormal compression of the third portion of the duodenum by the SMA. It has a low incidence rate, which is higher in young women, and is rarely associated with the Nutcracker phenomenon: a condition of the compression of the left renal vein between the SMA and the aorta, which manifests as pain in the left flank and pelvis. Here, we report on the case of a 54-year-old woman with a history of repeated episodes of abdominal pain caused by the Nutcracker syndrome and Wilkie’s syndrome. Full article

(This article belongs to the Special Issue Advances in the Diagnostic Imaging of Gastrointestinal Diseases)

12 pages, 5034 KiB

Open AccessArticle

YOLOv8-Based System for Nail Capillary Detection on a Single-Board Computer

by Seda Arslan Tuncer, Muhammed Yildirim, Taner Tuncer and Mehmet Kamil Mülayim

Diagnostics 2024, 14(17), 1843; https://doi.org/10.3390/diagnostics14171843 - 23 Aug 2024

Viewed by 160

Abstract

Nail capillaroscopic examination is an inexpensive and easily applicable method to identify capillary morphological changes in patients with conditions such as systemic sclerosis and Raynaud’s. The detection of changes in capillaries makes an important contribution to diagnosing these diseases. Capillary morphology is important [...] Read more.

Nail capillaroscopic examination is an inexpensive and easily applicable method to identify capillary morphological changes in patients with conditions such as systemic sclerosis and Raynaud’s. The detection of changes in capillaries makes an important contribution to diagnosing these diseases. Capillary morphology is important in the symptoms of these diseases, and capillary diameter, visibility, distribution, length, microbleeds, blood flow, and density are important indicators in capillaroscopic evaluation. Manual examination to determine these parameters is subjective, causes inconsistent results, and is labor-intensive and time-consuming. To overcome these problems, a YOLOv8s-based system was proposed in this paper to detect the number, thickness, and density of capillaries in the nail bed. The system’s components include database systems that store the analysis results, artificial intelligence-based software that runs on the SBC (Single-Board Computer), and recorded microscope images. mAP and F1_score parameters were used to evaluate the system’s performance, and values of 0.882 and 0.83 were obtained. The proposed system is promising in improving the diagnosis process of diseases such as systemic sclerosis and Raynaud’s by providing objective measurements and the early diagnosis and monitoring of diseases. Full article

(This article belongs to the Special Issue Deep Learning Techniques for Medical Image Analysis)

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25 pages, 139608 KiB

Open AccessReview

Neuroimaging in Nonsyndromic Craniosynostosis: Key Concepts to Unlock Innovation

by Camilla Russo, Ferdinando Aliberti, Ursula Pia Ferrara, Carmela Russo, Domenico Vincenzo De Gennaro, Adriana Cristofano, Anna Nastro, Domenico Cicala, Pietro Spennato, Mario Quarantelli, Marco Aiello, Andrea Soricelli, Giovanni Smaldone, Nicola Onorini, Lucia De Martino, Stefania Picariello, Stefano Parlato, Peppino Mirabelli, Lucia Quaglietta, Eugenio Maria Covelli and Giuseppe Cinalli Show full author list Hide full author list

Diagnostics 2024, 14(17), 1842; https://doi.org/10.3390/diagnostics14171842 - 23 Aug 2024

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Abstract

Craniosynostoses (CRS) are caused by the premature fusion of one or more cranial sutures, with isolated nonsyndromic CRS accounting for most of the clinical manifestations. Such premature suture fusion impacts both skull and brain morphology and involves regions far beyond the immediate area [...] Read more.

Craniosynostoses (CRS) are caused by the premature fusion of one or more cranial sutures, with isolated nonsyndromic CRS accounting for most of the clinical manifestations. Such premature suture fusion impacts both skull and brain morphology and involves regions far beyond the immediate area of fusion. The combined use of different neuroimaging tools allows for an accurate depiction of the most prominent clinical–radiological features in nonsyndromic CRS but can also contribute to a deeper investigation of more subtle alterations in the underlying nervous tissue organization that may impact normal brain development. This review paper aims to provide a comprehensive framework for a better understanding of the present and future potential applications of neuroimaging techniques for evaluating nonsyndromic CRS, highlighting strategies for optimizing their use in clinical practice and offering an overview of the most relevant technological advancements in terms of diagnostic performance, radiation exposure, and cost-effectiveness. Full article

(This article belongs to the Special Issue Advanced Neuroimaging Approaches for Brain Lesion)

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33 pages, 18210 KiB

Open AccessArticle

Ultrafast Brain MRI at 3 T for MS: Evaluation of a 51-Second Deep Learning-Enhanced T2-EPI-FLAIR Sequence

by Martin Schuhholz, Christer Ruff, Eva Bürkle, Thorsten Feiweier, Bryan Clifford, Markus Kowarik and Benjamin Bender

Diagnostics 2024, 14(17), 1841; https://doi.org/10.3390/diagnostics14171841 - 23 Aug 2024

Viewed by 286

Abstract

In neuroimaging, there is no equivalent alternative to magnetic resonance imaging (MRI). However, image acquisitions are generally time-consuming, which may limit utilization in some cases, e.g., in patients who cannot remain motionless for long or suffer from claustrophobia, or in the event of [...] Read more.

In neuroimaging, there is no equivalent alternative to magnetic resonance imaging (MRI). However, image acquisitions are generally time-consuming, which may limit utilization in some cases, e.g., in patients who cannot remain motionless for long or suffer from claustrophobia, or in the event of extensive waiting times. For multiple sclerosis (MS) patients, MRI plays a major role in drug therapy decision-making. The purpose of this study was to evaluate whether an ultrafast, T2-weighted (T2w), deep learning-enhanced (DL), echo-planar-imaging-based (EPI) fluid-attenuated inversion recovery (FLAIR) sequence (FLAIR_UF) that has targeted neurological emergencies so far might even be an option to detect MS lesions of the brain compared to conventional FLAIR sequences. Therefore, 17 MS patients were enrolled prospectively in this exploratory study. Standard MRI protocols and ultrafast acquisitions were conducted at 3 tesla (T), including three-dimensional (3D)-FLAIR, turbo/fast spin-echo (TSE)-FLAIR, and FLAIR_UF. Inflammatory lesions were grouped by size and location. Lesion conspicuity and image quality were rated on an ordinal five-point Likert scale, and lesion detection rates were calculated. Statistical analyses were performed to compare results. Altogether, 568 different lesions were found. Data indicated no significant differences in lesion detection (sensitivity and positive predictive value [PPV]) between FLAIR_UF and axially reconstructed 3D-FLAIR (lesion size ≥3 mm × ≥2 mm) and no differences in sensitivity between FLAIR_UF and TSE-FLAIR (lesion size ≥3 mm total). Lesion conspicuity in FLAIR_UF was similar in all brain regions except for superior conspicuity in the occipital lobe and inferior conspicuity in the central brain regions. Further findings include location-dependent limitations of signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) as well as artifacts such as spatial distortions in FLAIR_UF. In conclusion, FLAIR_UF could potentially be an expedient alternative to conventional methods for brain imaging in MS patients since the acquisition can be performed in a fraction of time while maintaining good image quality. Full article

(This article belongs to the Special Issue Artificial Intelligence in Brain Diseases)

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20 pages, 12078 KiB

Open AccessArticle

A Novel Algorithm for Forensic Identification Using Geometric Cranial Patterns in Digital Lateral Cephalometric Radiographs in Forensic Dentistry

by Shahab Kavousinejad, Mohsen Yazdanian, Mohammad Mahboob Kanafi and Elahe Tahmasebi

Diagnostics 2024, 14(17), 1840; https://doi.org/10.3390/diagnostics14171840 - 23 Aug 2024

Viewed by 159

Abstract

Lateral cephalometric radiographs are crucial in dentistry and orthodontics for diagnosis and treatment planning. However, their use in forensic identification, especially with burned bodies or in mass disasters, is challenging. AM (antemortem) and PM (postmortem) radiographs can be compared for identification. This study [...] Read more.

Lateral cephalometric radiographs are crucial in dentistry and orthodontics for diagnosis and treatment planning. However, their use in forensic identification, especially with burned bodies or in mass disasters, is challenging. AM (antemortem) and PM (postmortem) radiographs can be compared for identification. This study introduces and evaluates a novel algorithm for extracting cranial patterns from digital lateral cephalometric radiographs for identification purposes. Due to the unavailability of AM cephalograms from deceased individuals, the algorithm was tested using pre- and post-treatment cephalograms of living individuals from an orthodontic archive, considered as AM and PM data. The proposed algorithm encodes cranial patterns into a database for future identification. It matches PM cephalograms with AM records, accurately identifying individuals by comparing cranial features. The algorithm achieved an accuracy of 97.5%, a sensitivity of 97.7%, and a specificity of 95.2%, correctly identifying 350 out of 358 cases. The mean similarity score improved from 91.02% to 98.10% after applying the Automatic Error Reduction (AER) function. Intra-observer error analysis showed an average Euclidean distance of 3.07 pixels (SD = 0.73) for repeated landmark selections. The proposed algorithm shows promise for identity recognition based on cranial patterns and could be enhanced with artificial intelligence (AI) algorithms in future studies. Full article

(This article belongs to the Section Medical Imaging and Theranostics)

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28 pages, 1420 KiB

Open AccessReview

AI-Enhanced ECG Applications in Cardiology: Comprehensive Insights from the Current Literature with a Focus on COVID-19 and Multiple Cardiovascular Conditions

by Luiza Camelia Nechita, Aurel Nechita, Andreea Elena Voipan, Daniel Voipan, Mihaela Debita, Ana Fulga, Iuliu Fulga and Carmina Liana Musat

Diagnostics 2024, 14(17), 1839; https://doi.org/10.3390/diagnostics14171839 - 23 Aug 2024

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Abstract

The application of artificial intelligence (AI) in electrocardiography is revolutionizing cardiology and providing essential insights into the consequences of the COVID-19 pandemic. This comprehensive review explores AI-enhanced ECG (AI-ECG) applications in risk prediction and diagnosis of heart diseases, with a dedicated chapter on [...] Read more.

The application of artificial intelligence (AI) in electrocardiography is revolutionizing cardiology and providing essential insights into the consequences of the COVID-19 pandemic. This comprehensive review explores AI-enhanced ECG (AI-ECG) applications in risk prediction and diagnosis of heart diseases, with a dedicated chapter on COVID-19-related complications. Introductory concepts on AI and machine learning (ML) are explained to provide a foundational understanding for those seeking knowledge, supported by examples from the literature and current practices. We analyze AI and ML methods for arrhythmias, heart failure, pulmonary hypertension, mortality prediction, cardiomyopathy, mitral regurgitation, hypertension, pulmonary embolism, and myocardial infarction, comparing their effectiveness from both medical and AI perspectives. Special emphasis is placed on AI applications in COVID-19 and cardiology, including detailed comparisons of different methods, identifying the most suitable AI approaches for specific medical applications and analyzing their strengths, weaknesses, accuracy, clinical relevance, and key findings. Additionally, we explore AI’s role in the emerging field of cardio-oncology, particularly in managing chemotherapy-induced cardiotoxicity and detecting cardiac masses. This comprehensive review serves as both an insightful guide and a call to action for further research and collaboration in the integration of AI in cardiology, aiming to enhance precision medicine and optimize clinical decision-making. Full article

(This article belongs to the Section Machine Learning and Artificial Intelligence in Diagnostics)

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Diagnostics, Volume 14, Issue 17 (September-1 2024) – 16 articles

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